Arterial Spin-Labeling Parameters and Their Associations with Risk Factors, Cerebral Small-Vessel Disease, and Etiologic Subtypes of Cognitive Impairment and Dementia

Gyanwali, Bibek; Tan, Chuen Seng; Petr, Jan; Escobosa, L.L.T.; Vrooman, Henri A.; Chen, Christopher; Mutsaerts, Henk‐Jan; Hilal, Saima

doi:10.3174/ajnr.a7630

Cited by 11 publications

(11 citation statements)

References 43 publications

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“…We found increased aCBV near arterial regions of patients relative to controls, when modeling bolus dispersion and fitting all repetitions. This result is consistent with previous studies reporting more macrovascular artifacts in SVD patients than in healthy controls 27,28 . Our findings suggest that increases in aCBV may be associated with differences in bolus dispersion between groups that manifest as apparent differences in CBF when not appropriately accounting for dispersion in the kinetic model.…”

Section: Discussionsupporting

confidence: 93%

“…However, no healthy control group (without WMH) was considered in this study, which limits the comparability with our results. More recently, Gyanwali et al, performed a multiregression analysis on single‐delay data of a large cohort of elderly subjects including cerebral SVD, and found that lacunes and cerebral microbleeds were associated with lower CBF and higher ATT 28 . This analysis is not directly comparable to ours for two main reasons.…”

Section: Discussioncontrasting

confidence: 66%

“…More recently, Gyanwali et al, performed a multiregression analysis on single-delay data of a large cohort of elderly subjects including cerebral SVD, and found that lacunes and cerebral microbleeds were associated with lower CBF and higher ATT. 28 This analysis is not directly comparable to ours for two main reasons. On the one hand, ATT was not estimated by fitting a kinetic model to the data; instead, it was obtained by using the spatial coefficient of variation as a proxy.…”

Section: Interactions With Pathologycontrasting

confidence: 55%

“…This result is consistent with previous studies reporting more macrovascular artifacts in SVD patients than in healthy controls. 27,28 Our findings suggest that increases in aCBV may be associated with differences in bolus dispersion between groups that manifest as apparent differences in CBF when not appropriately accounting for dispersion in the kinetic model. This observation indicates that modeling dispersion may be of special importance when studying pathology.…”

Section: Interactions With Pathologymentioning

confidence: 88%

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Brain perfusion imaging by multi‐delay arterial spin labeling: Impact of modeling dispersion and interaction with denoising strategies and pathology

Monteiro

Pinto

Chappell

et al. 2023

Magnetic Resonance in Med

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PurposeArterial spin labeling (ASL) acquisitions at multiple post‐labeling delays may provide more accurate quantification of cerebral blood flow (CBF), by fitting appropriate kinetic models and simultaneously estimating relevant parameters such as the arterial transit time (ATT) and arterial cerebral blood volume (aCBV). We evaluate the effects of denoising strategies on model fitting and parameter estimation when accounting for the dispersion of the label bolus through the vasculature in cerebrovascular disease.MethodsWe analyzed multi‐delay ASL data from 17 cerebral small vessel disease patients (50 ± 9 y) and 13 healthy controls (52 ± 8 y), by fitting an extended kinetic model with or without bolus dispersion. We considered two denoising strategies: removal of structured noise sources by independent component analysis (ICA) of the control‐label image timeseries; and averaging the repetitions of the control‐label images prior to model fitting.ResultsModeling bolus dispersion improved estimation precision and impacted parameter values, but these effects strongly depended on whether repetitions were averaged before model fitting. In general, repetition averaging improved model fitting but adversely affected parameter values, particularly CBF and aCBV near arterial locations in patients. This suggests that using all repetitions allows better noise estimation at the earlier delays. In contrast, ICA denoising improved model fitting and estimation precision while leaving parameter values unaffected.ConclusionOur results support the use of ICA denoising to improve model fitting to multi‐delay ASL and suggest that using all control‐label repetitions improves the estimation of macrovascular signal contributions and hence perfusion quantification near arterial locations. This is important when modeling flow dispersion in cerebrovascular pathology.

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Section: Discussionsupporting

confidence: 93%

Section: Discussioncontrasting

confidence: 66%

Section: Interactions With Pathologycontrasting

confidence: 55%

Section: Interactions With Pathologymentioning

confidence: 88%

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Brain perfusion imaging by multi‐delay arterial spin labeling: Impact of modeling dispersion and interaction with denoising strategies and pathology

Monteiro

Pinto

Chappell

et al. 2023

Magnetic Resonance in Med

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“…In this regard, Mutsaerts et al proposed a quantitative measure called spatial coefficient of variation (sCoV) that can be used as ATT proxy, extractable from single-timepoint scans without requiring additional sequences [ 12 ]. The authors demonstrated in a cohort of older patients with hypertension that sCoV predicts ATT with high precision and could aid the clinical interpretation of ASL data, especially in patients with possibly compromised cerebral vasculature, as further investigated more recently on moyamoya [ 13 ], steno-occlusive disorder [ 14 , 15 ], and MCI/early dementia [ 7 , 16 , 17 ]. However, while a comprehensive evaluation of sCoV potential is provided in these articles, no study to date has investigated the agreement between this ATT proxy and a more practical qualitative visual assessment of individual hemodynamic patterns—which could be a useful tool in clinical practice.…”

Section: Introductionmentioning

confidence: 99%

Insights into single-timepoint ASL hemodynamics: what visual assessment and spatial coefficient of variation can tell

Pizzini,

Boscolo Galazzo,

Natale

et al. 2024

Radiol med

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Purpose Arterial spin labeling (ASL) represents a noninvasive perfusion biomarker, and, in the study of nonvascular disease, the use of the single-timepoint ASL technique is recommended. However, the obtained cerebral blood flow (CBF) maps may be highly influenced by delayed arterial transit time (ATT). Our aim was to assess the complexity of hemodynamic information of single-timepoint CBF maps using a new visual scale and comparing it with an ATT proxy, the “coefficient of spatial variation” (sCoV). Material and methods Individual CBF maps were estimated in a memory clinic population (mild cognitive impairment, dementia and cognitively unimpaired controls) and classified into four levels of delayed perfusion based on a visual rating scale. Calculated measures included global/regional sCoVs and common CBF statistics, as mean, median and standard deviation. One-way ANOVA was performed to compare these measures across the four groups of delayed perfusion. Spearman correlation was used to study the association of global sCoV with clinical data and CBF statistics. Results One hundred and forty-four participants (72 ± 7 years, 53% women) were included in the study. The proportion of maps with none, mild, moderate, and severe delayed perfusion was 15, 20, 37, and 28%, respectively. SCoV demonstrated a significant increase (p < 0.05) across the four groups, except when comparing none vs mild delayed perfusion groups (pBonf > 0.05). Global sCoV values, as an ATT proxy, ranged from 67 ± 4% (none) to 121 ± 24% (severe delayed) and were significantly associated with age and CBF statistics (p < 0.05). Conclusion The impact of ATT delay in single-time CBF maps requires the use of a visual scale or sCoV in clinical or research settings.

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Linking peripheral atherosclerosis to blood–brain barrier disruption: elucidating its role as a manifestation of cerebral small vessel disease in vascular cognitive impairment

Nyúl-Tóth,

Patai,

Csiszar

et al. 2024

GeroScience

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Aging plays a pivotal role in the pathogenesis of cerebral small vessel disease (CSVD), contributing to the onset and progression of vascular cognitive impairment and dementia (VCID). In older adults, CSVD often leads to significant pathological outcomes, including blood–brain barrier (BBB) disruption, which in turn triggers neuroinflammation and white matter damage. This damage is frequently observed as white matter hyperintensities (WMHs) in neuroimaging studies. There is mounting evidence that older adults with atherosclerotic vascular diseases, such as peripheral artery disease, ischemic heart disease, and carotid artery stenosis, face a heightened risk of developing CSVD and VCID. This review explores the complex relationship between peripheral atherosclerosis, the pathogenesis of CSVD, and BBB disruption. It explores the continuum of vascular aging, emphasizing the shared pathomechanisms that underlie atherosclerosis in large arteries and BBB disruption in the cerebral microcirculation, exacerbating both CSVD and VCID. By reviewing current evidence, this paper discusses the impact of endothelial dysfunction, cellular senescence, inflammation, and oxidative stress on vascular and neurovascular health. This review aims to enhance understanding of these complex interactions and advocate for integrated approaches to manage vascular health, thereby mitigating the risk and progression of CSVD and VCID.

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Arterial Spin-Labeling Parameters and Their Associations with Risk Factors, Cerebral Small-Vessel Disease, and Etiologic Subtypes of Cognitive Impairment and Dementia

Cited by 11 publications

References 43 publications

Brain perfusion imaging by multi‐delay arterial spin labeling: Impact of modeling dispersion and interaction with denoising strategies and pathology

Brain perfusion imaging by multi‐delay arterial spin labeling: Impact of modeling dispersion and interaction with denoising strategies and pathology

Insights into single-timepoint ASL hemodynamics: what visual assessment and spatial coefficient of variation can tell

Linking peripheral atherosclerosis to blood–brain barrier disruption: elucidating its role as a manifestation of cerebral small vessel disease in vascular cognitive impairment

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